Study Finds HIV-to-HIV Kidney Transplants Comparable in Effectiveness to Organs from Donors Without HIV

A new study led by Johns Hopkins Medicine found that “transplanting kidneys from deceased donors who had the human immunodeficiency virus (HIV) to recipients with HIV is safe. Perhaps more importantly, the study authors also found that HIV-to-HIV kidney transplants are comparable in effectiveness to those using organs from donors without HIV.”

Christine Durand, one of the study’s co-lead authors, says that the findings support “expanding HIV-to-HIV kidney transplants from their current ‘research-only’ authorization — as enabled by Congress passing the HIV Organ Policy Equity [HOPE] Act in 2013 — to routine clinical practice.” Past findings on a case series involving the first donor to receive an HIV-to-HIV kidney transplant in the U.S. led researchers to conclude that “people with HIV can safely donate kidneys without an increased risk of developing end-stage kidney disease or other kidney problems later in life.”

In this new study, researchers evaluated “198 kidney transplant recipients with HIV — 99 who received their organ from a deceased donor with HIV and 99 who received theirs from a donor without HIV. The researchers evaluated both patient groups for primary negative outcomes known as “safety events,” such as death from any cause, graft loss (failure of the transplanted organ), serious adverse complications, a breakthrough HIV infection, persistent failure of HIV treatment, or an opportunistic infection. Secondary outcomes studied included overall patient survival, survival without graft loss, organ rejection, infection, cancer and an HIV superinfection (when a PWH is infected with a second strain of HIV).”

The hazard ratio for each of the primary outcomes was “approximately 1, which shows ‘noninferiority’ of the HIV-to-HIV kidney transplant procedure…This means statistically, it is just as safe and effective as transplants using a kidney from a donor without HIV.”